| NPI | 1184847790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD S MILLER President 781-961-2123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA 12239) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 11787) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2025-09-11 |